MEDICARE: DR. AHMED SADEK D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics	58267	CA

General Provider Information

NPI Number	:	1629062096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AHMED SADEK D.D.S.

Provider Business Mailing Address
First Line	:	6511 E PACIFIC COAST HWY # G-3
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90803-4248
Country	:	US
Telephone Number	:	562-431-3636
Fax Number	:

Provider Business Practice Location Address
First Line	:	6511 E PACIFIC COAST HWY # G-3
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90803-4248
Country	:	US
Telephone Number	:	562-431-3636
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	10/25/2010

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